Teen Depression (cont.)

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

What is teen depression?

Clinically significant depression can be broadly understood as depression that is severe enough that it interferes with the person's ability to function in some way. It is quite common in every age group, affecting more than 16% of the population in the United States at some point in their lifetime. Depression occurs at a rate of about 2% during childhood and from 4%-7% during adolescence. This illness is a leading cause of health impairment (morbidity) and death (mortality).

Depression is common during the teenage years, affecting about 20% of adolescents by the time they reach adulthood. Other statistics about teen depression include that over 8% of adolescents suffer from depression that lasts a year or more.

What are causes and risk factors for depression in teenagers?

As with most mental-health disorders, depression in teens does not have one single definitive cause. Rather, people with this illness tend to have a number of biological, psychological, and environmental risk factors that contribute to its development. Biologically, depression is associated with a reduced level of the neurotransmitter serotonin in the brain, a decrease in the size of some areas of the brain, as well as increased activity in other areas of the brain. Females are more likely to get depression than males, but that is thought to be the result of, among other things, a combination of biological differences based on gender, as well as the differences in how girls and women are encouraged to interpret their environment and respond to it compared to men and boys. There is thought to be at least a partially genetic contribution to the development of depression because children and adolescents with a depressed parent are up to four times more likely to develop the illness themselves. Teens who develop depression are also more prone to having other biological challenges, like low birth weight, trouble sleeping, and having a mother younger than 18 years old at the time of their birth.

Psychological risk factors for depression include low self-esteem, poor body image, a tendency to be highly self-critical, and feeling helpless when dealing with negative events. Teen depression and other mood disorders are somewhat associated with the stress of body changes, including the fluctuating hormones of puberty, as well as teen ambivalence toward increased independence, and with changes in their relationships with parents, peers, and others. Teenagers who suffer from conduct disorder, attention deficit hyperactivity disorder (ADHD), clinical anxiety, or who have cognitive and learning problems, as well as trouble relating to others are at higher risk of also developing depression.

Depression may be a reaction to environmental stresses, including trauma like verbal, physical, or sexual abuse, the death of a loved one, school problems, or being the victim of bullying or peer pressure. Gay teens are at higher risk for depression, thought to be because of the bullying by peers and potential rejection by family members. Teens in military families have been found to be at risk for experiencing depression, as well.

The aforementioned environmental risk factors tend to specifically predispose individuals to depression. Other risk factors tend to predispose people to depression as well as putting them at risk for other problems. Such nonspecific risk factors for depression include poverty, exposure to violence, having an antisocial peer group or being socially isolated, abuse victimization, parental conflict, and family dissolution. Teens who have low physical activity, poor academic performance, or lose a relationship are at higher risk for depression.